In search of the perfect crystal ball for Ta urothelial cancer.

摘要

Urothelial cancer (UC), with its characteristic polychrono-tropism and wide spectrum of virulence, has long presented a therapeutic challenge for urologists. Although the majority of UCs are non-muscle invasive, up to 70% recur, and although only 2% of Ta G1-2 and 10-15% of Ta G3 cancers progress, those patients who do progress have a guarded prognosis despite radical cystectomy. For any given clinical Ta cancer, being able to determine the propensity for subsequent recurrence and progression confers a tremendous benefit in terms of customizing the intensity of surveillance and in terms of whether to institute preventative measures such as intravesical immuno- or chemotherapy, whether to use adjunctive diagnostic and staging measures, and whether to plan definitive ablative treatment. A reliable, practical, and accurate "crystal ball" for Ta UC has significant implications in terms of health care economics and patient survival.